Publications by authors named "Juan R Vilaro"
Introduction: Diuretics are the mainstay of maintaining and restoring euvolemia in the management of heart failure. Loop diuretics are often preferred, however, combination diuretic therapy (CDT) with a thiazide diuretic is often used to overcome diuretic resistance and increase diuretic effect. We performed an analysis of the GUIDE-IT study to assess all-cause mortality and time to first hospitalizations in patients necessitating CDT.
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- The study reviews how cognitive frailty assessment impacts outcomes for patients receiving left ventricular assist devices (LVAD), highlighting variability in findings and assessment methods.
- There were 12 studies involving over 16,000 patients, primarily using the Montreal Cognitive Assessment, with mixed results on outcomes like length of hospital stay, readmissions, and mortality.
- The authors suggest that cognitive frailty may worsen post-LVAD outcomes but call for better standardization in reporting and further research to clarify its prognostic implications.
Article Synopsis
- - The text discusses two difficult cases of cardiac transthyretin amyloidosis that were initially misdiagnosed as cardiac amyloidosis due to light chain issues linked to active myeloma.
- - An endomyocardial biopsy combined with mass spectrometry was crucial for accurately diagnosing the condition.
- - The correct diagnosis was important for guiding the appropriate treatment for these patients.
Minorities are less likely to receive a left ventricular assist device (LVAD). This, however, is based on total implant data. By examining rates of LVAD implant among patients admitted with heart failure complicated by cardiogenic shock, we sought to further elucidate LVAD utilization rates and racial disparities.
View Article and Find Full Text PDFBackground: Intra-aortic balloon pump (IABP) and Impella device utilization as a bridge to heart transplantation (HTx) have risen exponentially. We aimed to explore the influence of device selection on HTx outcomes, considering regional practice variation.
Methods: A retrospective longitudinal study was performed on a United Network for Organ Sharing (UNOS) registry dataset.
Heart failure carries significant morbidity and mortality and affects a large population of patients cared for predominantly by primary care physicians. The complexity of managing heart failure patients is increasing as new therapies continue to emerge. This review outlines important clinical pearls and proposes strategies for optimization of medical therapy.
View Article and Find Full Text PDFIntroduction: Artificial intelligence can recognize complex patterns in large datasets. It is a promising technology to advance heart failure practice, as many decisions rely on expert opinions in the absence of high-quality data-driven evidence.
Methods: We searched Embase, Web of Science, and PubMed databases for articles containing "artificial intelligence," "machine learning," or "deep learning" and any of the phrases "heart transplantation," "ventricular assist device," or "cardiogenic shock" from inception until August 2022.
Frailty is associated with poor clinical outcomes in heart failure patients. The impact of frailty on outcomes following left ventricular assist device (LVAD) implantation, however, is less clearly defined. We therefore sought to conduct a systematic review to evaluate current frailty assessment strategies and their significance for patients undergoing LVAD implantation.
View Article and Find Full Text PDFLeft ventricular assist device (LVAD) implantation is increasingly utilized in patients with advanced heart failure and morbid obesity. Laparoscopic sleeve gastrectomy (LSG) can facilitate weight loss in this population and can ultimately change the pharmacokinetics of heart failure therapeutics. In this study, we aimed to explore the changes in cardiovascular pharmacotherapy post LSG intervention.
View Article and Find Full Text PDFStudy Objective: Early bleeding is a common source of morbidity associated with left ventricular assist device (LVAD) implantation. Our objective was to identify potential predictors of peri-implant bleeding.
Methods: We conducted a retrospective cohort study of LVAD implants at our institution between January 2010 and November 2018.
Intravenous inotropic therapy can be used in patients with advanced heart failure, as palliative therapy or as a bridge to cardiac transplantation or mechanical circulatory support, as well as in cardiogenic shock. Their use is limited to increasing cardiac output in low cardiac output states and reducing ventricular filling pressures to alleviate patient symptoms and improve functional class. Many advanced heart failure patients have sinus tachycardia as a compensatory mechanism to maintain cardiac output.
View Article and Find Full Text PDFLeadless pacemaker use in a patient with a durable left ventricular assist device.
Pacing Clin Electrophysiol
September 2020
There is limited known safety and efficacy of leadless pacemaker device use in patients with durable left ventricular assist devices (LVADs). We present a case of a pacemaker-dependent LVAD patient with infection of permanent transvenous pacemaker who underwent successful implantation of Micra transcatheter pacing system (Medtronic).
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